JACMEL, HAITI -- After 2 1/2 days of travel, over the sea, across borders, in planes so small they had to leave most of their food and water behind, the emergency relief workers from Northern Virginia had finally arrived.

They found that the hospital courtyard in Jacmel had become a village of the injured and their families, a community living under tarps, with laundry stretched out on rubble to dry and a large black pig wandering by the ruins of the maternity ward.

Jacmel, a beautiful city on the southern coast of Haiti, known for its artists, its pastel colonial houses and its carnival, had been hit hard by the earthquake and left with almost no functioning medical care. But hope remained. Residents here were still pulling out a few people from under buildings -- alive.

The crew from Community Coalition for Haiti, with doctors and ER nurses from Inova Fairfax Hospital, was glad to finally join the effort, after a crazy, roundabout trip full of mishaps, the same kind of journey that many relief workers faced as they tried to get into the chaos of a devastated country.

The CCH group left Washington before dawn Sunday, flew to Santiago in the Dominican Republic, then got up before dawn again to catch another flight. It was a race that ended like a flat tire at the border with Haiti on Monday.

The relief workers found themselves caught in a throng of thousands of people on market day, women weaving about with huge sacks of macaroni balancing on their heads, small boys tapping at the glass of the CCH bus, asking for food. They waited, stuck without their passports, for the trip leaders to arrive in a truck and get them through the border.

When they finally inched across the narrow bridge to Haiti, they knew they had probably missed their chance at a flight but rushed toward the airfield at Pignon anyway. They crammed people into a pickup truck for a jolting and bruising ride over rough dirt roads through mountains, veering around goats and ditches, fording streams and rattling through small villages, with a doctor on the back clinging to the pile of medical supplies and luggage.

They missed the flight, by a long shot. The next morning, as the sun rose, a Haitian boy shooed goats off the airfield as two six-seater planes arrived to fly them to Jacmel.

Once here, they dropped their tents at the convent where they would be sleeping and headed for the hospital. They were among the first overseas medical teams to arrive.

They found patients lying on beds of bright green planks pulled from the rubble. A girl held an IV drip for her sister, who was on a bed mat, sweat pouring off of her face, which was twisted in agony.

The patients were all outside. Tarps protected them from the almonds that dropped from trees overhead. But it was unbearably hot there, with families bringing meals and living alongside the injured crammed into the small courtyard.

Close enough to reach out and touch one another, patients lay moaning as volunteers wrapped gauze around injuries.

A small boy stood, hands on his head, mouth trembling, as he watched a doctor check his sister's leg.

A woman on crutches limped up the hill toward the tarps. Another, with bandages all over her head, dropped onto a bench, whimpering softly in the midst of the crowd. Another slept on a low concrete wall covered in white dust.

And more people were waiting at the gates.

Ted Alexander, an orthopedic surgeon from Inova, stepped out from under a tarp.

"I looked at one of the guillotine amputations they did at the shoulder," he said.

He was preparing to do an amputation himself as soon as the anesthesiology equipment was hooked up. The 55-year-old woman's arm was black and necrotic, one of many injuries that had gone untreated or had been given only the crudest first aid.

Nearby, a cluster of women waited for news outside the improvised operating room. They were friends of a woman who was killed with all but one of her children when her house collapsed. One girl, her legs crushed, had survived.

Russell Seneca, chairman of the surgery department at Inova Fairfax, was with some of the doctors who had just operated on the girl. He spoke to the waiting women through a translator. "She's going to be fine," he said, and their eyes widened with amazement.